5 - Association Between Dental Prophylaxis and Pneumonia in Kentucky Medicaid Beneficiaries

Abstract:

Objectives: The purpose of this study was to investigate the relationship between dental prophylaxis (DP) use and pneumonia risk among adult Kentucky Medicaid beneficiaries with and without type 2 diabetes mellitus (T2DM).

Methods: Kentucky Medicaid claims data 2014-2019 were used to build a longitudinal database. The study sample included 780,113 beneficiaries aged ≥ 21 years. Pneumonia incidence rates (IRs) of five-year follow-up periods for DP were examined. Multiple Cox regression analysis was performed to evaluate the impact of DP on pneumonia incidence among beneficiaries with and without T2DM.

Results: The IR of pneumonia among beneficiaries was 3.76%/year (95% confidence interval (CI): 3.74% – 3.79%). Cox regression analysis showed that beneficiaries who received DP had a lower risk of pneumonia compared to those who did not have DP (adjusted hazard ratio (HR) = 0.70; 95% CI, 0.69 – 0.71; p < 0.001), adjusting for sociodemographic (e.g., age, sex, race, urban/rural residence), tooth extraction, T2DM, other co-morbidities (e.g., hypertension, dyslipidemia, peripheral vascular disease, chronic kidney disease, atrial fibrillation), and statin. After adjustment for confounders, beneficiaries who had T2DM were 23% more likely to have a pneumonia than those without T2DM (adjusted HR = 1.23; 95% CI, 1.21 – 1.25; p < 0.001).

Conclusions: DP was associated with decreased risk of pneumonia among adult Kentucky Medicaid beneficiaries with and without T2DM. DP coverage should be continued for adult Medicaid beneficiaries, especially those with T2DM to reduce the risk of pneumonia.

Source of Funding: This study received financial support from the State University Partnerships between Kentucky CHFS and University of Louisville.